Observational study about the incidence of relative adrenal insufficiency in patients with cirrhosis and acute variceal bleeding; in patients with acute peptic gastrointestinal bleeding and without liver disease; and in patients with severe acute pancreatitis.

This is a study using pharmaceutical specialties in the approved conditions of use.

Observational, prospective, open-label, in-patient study, that includes patients with upper gastrointestinal bleeding of variceal or peptic origin, and in patients with severe acute pancreatitis.

The adrenal function of every patient included will be evaluated in the first 24 hours of admission This assessment shall be performed using the corticotropin-stimulation short test (synacthen test), that includes serum and saliva determination of cortisol, in basal conditions and 30 and 60 minutes after the administration of 250 ug of corticotropin synthetic (Synacthen, Novartis Pharma AG, Basel, Switzerland).

Treatment during the 30 days prior to inclusion with any of the following drugs: contraception, etomidate, ketoconazole, rifampin or phenytoin.

History of cranial trauma or surgery.

Any malignancy in treatment or progression.

HIV infection.

Prior known adrenal pathology.

Patients not eligible to any active treatment because the existence of any clinical condition considered terminal.

Patients with associated traumatic blood loss, or any other extraintestinal source of active bleeding.

Burns.

Patients who have been previously included in this study.

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Please refer to this study by its ClinicalTrials.gov identifier: NCT00562445